What is Emily Teesdale's NPI number?

The NPI number assigned to this healthcare provider is 1982126009, enumerated as a individual on July 11, 2017.

Where is the provider located?

The provider is located at 145 MICHIGAN ST NE STE 3410 GRAND RAPIDS, MI 49503 and the phone number is (616) 391-9945.

What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LG0600X and a focus in Gerontology.

MRS. EMILY LUCILLE TEESDALE A-GNP - NPI 1982126009 - Nurse Practitioner in Grand Rapids, MI

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About Mrs. Emily Lucille Teesdale A-gnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. EMILY LUCILLE TEESDALE A-GNP (NPI 1982126009) is an individual gerontology provider in Grand Rapids, Michigan, licensed in Michigan (4704274128) and active in the NPI registry since July 2017.

NPPES Registry Identity

NPI1982126009

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMRS. EMILY LUCILLE TEESDALECredential: A-GNP

Location Address145 MICHIGAN ST NE STE 3410Grand Rapids, MI 49503-2563

Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560

Phone(616) 391-9945

Sole ProprietorNo

Enumeration DateJuly 11, 2017

Last NPPES UpdateJuly 20, 20228 updates tracked since enumeration

NPPES CertifiedJuly 20, 2022

✔ NPI 1982126009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in MI · 4704274128

145 MICHIGAN ST NE STE 3410, Grand Rapids, MI 49503

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRETCHEN S HOLT-VREDEVOOGD PA-C

Physician Assistant (Medical)